Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

79 questions · 125 findings · 14 reviews · All outcomes

No studies found 4 · 3.2%GRADE not reported 78 · 62.4%Very low 28 · 22.4%Low 12 · 9.6%Moderate 3 · 2.4%High 0 · 0%

Relaxation vs Occlusal (oral) appliance

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Relaxation showed no clear difference in pain intensity compared with occlusal (oral) appliance; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion · Adolescents (12-19 years)
    Not pooled. Wahlund 2015: MD 3.70 (95% CI -1.21 to 8.61), n=57 (relaxation 28, appliance 29); Wahlund 2003: MD not reported, n=83 (relaxation 41, appliance 42). Both studies were in adolescents; the occlusal appliance…
    2 studies · 140 participants
    GRADE not reported

Hope-based intervention vs Pain education

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hope-based intervention showed no clear difference in pain intensity compared with pain education; GRADE not reported.

1 finding from 1 review

Mindfulness plus medication vs Medication alone

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

Hypnosis vs relaxation

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hypnosis showed no clear difference in pain intensity compared with relaxation; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion
    Not pooled (clinical heterogeneity). Abrahamsen 2011: MD -1.00 (95% CI -2.27 to 0.27), n=38 (hypnosis 19, relaxation 19); Stam 1984: MD not reported, n=27 (hypnosis 12, relaxation 15).
    2 studies · 65 participants
    GRADE not reported

Habit reversal vs waiting list control

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Habit reversal treatment led to lower pain intensity compared with waiting-list control; GRADE not reported.

1 finding from 1 review

Education vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

CBT plus hypnosis (combined package) vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

CBT plus hypnosis (combined package) led to lower pain intensity compared with usual care; GRADE not reported.

1 finding from 1 review

Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
1 finding from 1 review

Oral celecoxib (COX-2 inhibitor) vs placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral celecoxib (COX-2 inhibitor) showed no clear difference in pain intensity (VAS) compared with placebo; GRADE not reported.

1 finding from 1 review

Naproxen vs placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral naproxen (NSAID) led to lower pain intensity (VAS) compared with placebo; GRADE not reported.

1 finding from 1 review

Oral glucosamine hydrochloride/chondroitin sulphate vs placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral glucosamine hydrochloride/chondroitin sulphate showed no clear difference in pain intensity (VAS) compared with placebo; GRADE not reported.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower pain intensity (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Reduction in pain intensity · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to higher pain intensity (short term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs placebo or control

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) probably leads to lower pain intensity (VAS 0-100 mm) compared with control (placebo or no treatment) (moderate certainty).

3 findings from 1 review

Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

It is very uncertain whether ibuprofen taken pre-emptively (about 1 hour before treatment) changes pain intensity (VAS 0-100 mm) compared with ibuprofen taken post-treatment (very low certainty).

3 findings from 1 review

NSAID (systemic) vs paracetamol

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

NSAID (systemic) showed no clear difference in pain intensity (VAS 0-100 mm) compared with paracetamol (low certainty).

3 findings from 1 review

Topical NSAID (ketoprofen chewing gum) vs Local anaesthetic (benzocaine chewing gum)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

It is very uncertain whether topical NSAID (ketoprofen chewing gum) changes pain intensity (VAS 0-100 mm) compared with local anaesthetic (benzocaine chewing gum) (very low certainty).

1 finding from 1 review